Information About Induction of Labour (IOL)
- Dr Kenga Sivarajah
- Sep 24
- 3 min read
We understand that deciding how your baby is born is a very personal choice. This guide explains what induction of labour (IOL) involves, why it may be recommended, and what alternatives you might wish to consider.
What Is Induction of Labour?
Induction of labour is when labour is started with medicines or medical procedures, rather than waiting for it to begin naturally. Around one-third of pregnancies in the UK are induced.
What Research Tells Us
ARRIVE Trial (2018)
Inducing labour at 39 weeks did not increase the risk of complications for babies such as stillbirth, serious illness, or admission to neonatal intensive care.
Women who had induction at 39 weeks were slightly less likely to need a caesarean compared with those who waited for labour to start naturally.
Labour itself was often longer, but the hospital stay afterwards was usually shorter.
Cochrane Review (2020)
Induction from 37 weeks onwards was linked with fewer caesarean births and a reduced risk of neonatal death.
It did not increase the likelihood of needing forceps, ventouse, or other assisted births.
What to Expect With Induction of Labour
Preparation and Monitoring
Vaginal examinations are needed to assess the cervix before and during induction.
Sometimes, continuous monitoring of the baby’s heartbeat is recommended. This usually means giving birth in hospital rather than at home or in a midwife-led unit.
The Induction Process
Induction can take time—sometimes 2–3 days from the start to active labour.
It usually begins with medication placed in the vagina (Propess) or small rods that gently open the cervix (Dilapan).
If needed, your waters may then be broken (artificial rupture of membranes, ARM) and a hormone drip (Syntocinon) starts to bring on contractions.
How It May Feel
Some people find induced labour more intense or painful than labour that starts naturally, although experiences vary.
Pain relief is always available, and you will be supported to make choices that feel right for you.
Possible Risks of Induction
Strong or frequent contractions (tachysystole), which may affect the baby’s heart rate.
Higher chance of needing an emergency caesarean if induction is unsuccessful.
A slightly increased risk of serious perineal tears (3rd or 4th degree), possibly linked to more epidurals and instrumental births.
Alternatives – Elective Caesarean Section (ELCS)
Choosing a planned caesarean is another option. This is major surgery, and it carries
its own risks:
Bleeding, infection, or damage to nearby organs or blood vessels.
Babies may have temporary breathing difficulties requiring short-term neonatal care.
Slower recovery and longer hospital stay.
Increased risk of complications in future pregnancies (such as placenta problems).
Small but real risks of blood clots and maternal mortality.
Things to Consider
Induction can change the birth experience compared to labour that starts on its own.
Your choices about where and how to give birth may be affected by the monitoring or treatments needed.
Every pregnancy is unique—what feels right for one person may not be right for another.
Support and Decision-Making
We want you to feel informed, supported, and involved in every step. You will always have the opportunity to ask questions, discuss your preferences, and make choices that feel best for you and your baby.
Frequently Asked Questions (FAQs) about Induction of Labour
Will induction hurt more than natural labour?
Some women find induced labour more intense and painful, but others do not notice a big difference. Everyone’s experience is unique. Pain relief options are always available to support you.
How long will induction take?
It can sometimes take 2–3 days from starting induction to being in established labour. For some women it happens more quickly, while for others it may take longer.
Can I still move around and use different positions?
Yes, in many cases you can still move around and use upright positions. However, if continuous monitoring is recommended, your movement may be more limited.
Will induction increase my chance of a caesarean?
Research shows that induction at or after 39 weeks does not increase your chance of caesarean and may slightly reduce it compared to waiting for labour to start naturally.
Can I have a water birth if I’m induced?
It depends on how your labour progresses and whether you need continuous monitoring or certain medications. In some cases, water birth may not be possible.
What happens if induction doesn’t work?
If induction does not successfully start labour, your doctor will discuss the next steps with you. This may include trying another method of induction or recommending a caesarean birth.
Can my birth partner stay with me?
Yes, your birth partner can usually stay with you during the induction process and throughout your labour and birth.